Here are several points of information about for of the country's leading regional health systems — Intermountain Healthcare, Sentara Healthcare, Aurora Health Care and UnityPoint Health.
1. Headquarters and service area. Each system is based primarily in one home state and has significant expansion outside of their home region, with the exception of Aurora.
Salt Lake City-based Intermountain Healthcare serves the "Intermountain West" region between the Rocky Mountains and the Cascade Range and Sierra Nevada Range. Its service area includes Utah and southeastern Idaho.
Norfolk, Va.-based Sentara Healthcare serves the "Hampton Roads" region, which is centered around Virginia Beach, Norfolk and Newport News, Va. Sentara's service area reaches into North Carolina as well.
Milwaukee-based Aurora Health Care is heavily based in eastern Wisconsin, with some spillover the state border into northern Illinois.
Des Moines, Iowa-based UnityPoint Health serves Iowa, Illinois and Wisconsin.
2. Number of hospitals per system. Intermountain boasts 22 hospitals, Sentara consists of 12 hospitals, Aurora is comprised of 15 hospitals and UnityPoint operates 17 hospitals.
3. Executive leadership. Intermountain is led by a four-member management committee: President and CEO Charles W. Sorenson, MD, Executive Vice President and COO Laura S. Kaiser, Executive Vice President and CFO Bert Zimmerli, and Senior Vice President and Chief Strategy Officer Gregory Poulsen. Marc Probst serves as vice president and CIO and Brent E. Wallace, MD, serves as CMO.
Sentara is led by CEO David L. Bernd, Senior Vice President and CFO Robert A. Broermann, Senior Vice President and CMO Terry Gilliland, MD, and Senior Vice President and CIO Bertram Reese.
Aurora is led by President and CEO Nick Turkal, MD, CFO Gail Hanson, CIO Philip Loftus, PhD, and Executive Vice President and CNO Mary Beth Kingston.
Unity Point is led by President and CEO Bill Leaver, Senior Vice President and CFO Mark Johnson, Senior Vice President and Chief Clinical Officer Alan S. Kaplan, MD, and Vice President and CIO Joy M. Grosser.
4. Origin. Intermountain was established in 1975 when The Church of Jesus Christ of Latter-Day Saints donated a 15-hospital system to the communities they served, with the condition it remain a nonprofit system. The system has since expanded to include seven more hospitals and restructured in 1991 into three main branches: hospitals, physicians and health plans.
Sentara dates back to 1888 with the establishment of the 25-bed "Retreat for the Sick" in Norfolk, Va., which later became Norfolk Protestant Hospital and then Norfolk General. Other hospitals began cropping up in the early 1900s, and they eventually became part of the Sentara system. Many mergers later, the system became Sentara in 1986.
Aurora got its start in 1984 when St. Luke's Medical Center and Good Samaritan Medical Center became St. Luke's Samaritan Health Care. Three years later, the system was named Aurora Health Care, following a merger between Mt. Sinai Medical Center and Good Samaritan Medical Center.
UnityPoint originated in 1993 when Iowa Lutheran Hospital and Iowa Methodist Hospital in Des Moines merged to become Iowa Health System. Now encompassing nine metropolitan areas in multiple states, the system changed its name to UnityPoint in 2013.
5. Revenue. Intermountain reported $5.4 billion in revenue for 2013, Sentara reported $4.3 billion, Aurora reported $4.1 billion and UnityPoint reported $2.8 billion.
6. Areas of excellence. Intermountain is known as one of the most integrated health systems in the country, ranking in the top five systems for integration by IMS Health and SDI Health. This point of recognition has come up in political debates and speeches. President Barack Obama referenced Intermountain in his speeches to Congress and the American Medical Association in 2009, saying the system offers high-quality care at below-average costs. The system was named a "Most Wired" hospital system this year by Hospitals & Health Networks. It is also well-known for its organ donation services. Provo-based Utah Valley Regional Medical Center received a Gold Medal of Honor for organ donations from HHS and three other Intermountain hospitals received silver medals. U.S. News & World Report ranked the system's Salt Lake City-based Primary Children's Hospital as one of the nation's top 50 children's hospitals for eight specialties, including orthopedics, neurology and neurosurgery.
Sentara, also a highly integrated system, has received recognition for its health IT strategy. In 2012, it was named a "Most Wired" system by Hospitals & Health Networks. U.S. News & World Report ranked Sentara's flagship hospital, Norfolk General, the No. 1 hospital in Virginia. It was also ranked nationally for heart and ear, nose and throat programs and was redesignated as a Magnet Hospital by American Nurse Credentialing Center. Sentara's nursing centers are also regularly recognized as top nursing homes by U.S. News & World Report. Four centers received five-star rankings in 2014.
Aurora is well-known for its homecare services. In 2009, the system reported two thirds of care was delivered outside of hospitals. It also has a reputation for providing excellent cardiology services. Milwaukee-based St. Luke's Medical Center has delivered more than 800 heart transplants and is the only Wisconsin hospital ranked nationally for cardiology and heart surgery by U.S. News & World Report in 2014-15. Aurora St. Luke’s also received the highest national ranking in Wisconsin for gastroenterology and GI surgery by U.S. News & World Report. Green Bay, Wis.-based Aurora BayCare Medical Center was also recognized as a top hospital in northeastern Wisconsin with high performance in orthopedics and urology. The system was also named a "Most Wired" system multiple times.
UnityPoint touts a "physician-led" culture in which its physicians are able to develop leadership skills and play a key role in making decisions for the system. Its Des Moines-based Iowa Methodist Medical Center was recognized as high performing in cancer, gynecology, nephrology and urology by U.S. News & World Report. It was also recognized as a Blue Distinction Center Plus for cardiac care. The system's Des Moines, Iowa-based John Stoddard Cancer Center is an accredited breast center by the American College of Surgeons. It wasone of 74 cancer centers nationwide to receive the 2013 Outstanding Achievement Award from the Commission on Cancer and was designated a Blue Distinction Center for Complex and Rare Cancers. It also received a "Most Wired" designation.
7. Legal issues. In April 2013, Intermountain agreed to pay $25.5 million to settle allegations it violated the Stark Law and the False Claims act for participating in improper financial relationships with referring physicians. Intermountain self-disclosed issues to the U.S. government, which included employment agreements between Intermountain and physicians with bonuses adjusted based on patient referrals and office leases and compensation agreements that violated the Stark Statute.
8. Employed physicians. Intermountain employs 1,100 primary care and secondary care physicians, Sentara employs 700 physicians and advanced practice clinicians, Aurora employs 1,500 physicians and UnityPoint employs more than 900 physicians and specialists.
9. Flagship hospital. Intermountain's main hospital is the 472-bed Intermountain Medical Center in Murray, Utah. Sentara's flagship location is the 525-bed Norfolk (Va.) General Hospital. Aurora's primary hospital is the 680-bed St. Luke's Medical Center in Milwaukee. UnityPoint's main hospital is the 372-bed Des Moines-based Iowa Methodist Medical Center.
10. A strategic question. An important question facing great regional systems is whether they should remain regional or get larger and span across bigger areas. Is the better answer to achieve and maintain dominance in their core areas? This is an evolving question, discussed further in "Healthcare strategy 2015 — Back to the basics: 12 key thoughts."